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Salivary gland tumours are relatively uncommon, and there exists a considerable diagnostic difficulty owing to their diverse histological features in individual lesions and the presence of a number of types and variants, in addition to overlapping histological patterns similar to those observed in different tumour entities. One such group of variations is clear cell tumours of oral cavity which constitute an assorted group of lesions that may be odontogenic or metastatic or of salivary gland origin. The clear cell variant of mucoepidermoid carcinoma is at times misleading to the clinician because of its atypical location and innocent appearance. The pathologist needs to be familiar with the molecular alterations so that there may be a strong potential to implement good treatment. Hereby, we report a rare case of intraosseous clear cell variant of mucoepidermoid carcinoma which histopathologically posed challenges due to its variable presentation, suggesting the need for histochemical stains and molecular work-up for a definitive diagnosis and a better therapeutic and prognostic insight.

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Malignant odontogenic neoplasms are extremely challenging to study due to their rarity and variable clinical presentations. Ameloblastic carcinoma (AC) is one such odontogenic tumor which has been the subject of controversy, in part because of its scarcity, complicated by confusion in terminology along with complexity in classification. Histologic features of AC resemble tumor cells of ameloblastoma but exhibit cellular atypia. Surgical resection for this kind of lesion, leaving at least a 2 cm free margin coupled with neoadjuvant radiotherapy, might prove fruitful results. The current paper reports a case of an extraosseous variant of AC which posed a diagnostic challenge due to variable presentations histopathologically, suggesting the need for evidence-based case studies and molecular workup for a better therapeutic and prognostic insight.

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BACKGROUND: Phytoceuticals have been used extensively worldwide due to their reduced toxicity and therapeutic efficacy. The major drawback associated with their delivery which includes lack of sustained action and lipophilicity has been overcome by applications of scientific approach by scientists and researchers. Novel drug delivery systems aimed at enhancing bioavailability, reducing toxicity and in turn improving the patient compliance have been developed with success in recent times. Recent developments in the modern phytopharmaceutical research methods have also solved the major hurdles related to the extraction, identification of constituents in polyherbal systems, and standardisation thereby further facilitating the formulation of improved dosage forms like nanoemulsions with better efficacy of the herbal drugs. METHOD: We did extensive literature review, which included an in depth study and collection of both peer reviewed research and review manuscripts as well as patents related to phytonanoemulsions, which were included in the manuscript. RESULTS: In this article, an attempt has been made to compile the therapeutic and non therapeutic applications of herbal drugs formulated as nanoemulsions, patented phytonanoemulsions, with a discussion on the toxicity and future aspects of the nanoemulsion based delivery of phytotherapeutics. CONCLUSION: The findings of the review confirm that phytonanoemulsions are novel formulations which can be utilized both for therapeutic as well as nontherapeutic applications.

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BACKGROUND: Sexual dimorphism has been of great interest to anthropologists and odontologists. Dental measurements are important in anthropology for the study of sexual dimorphism with most common being the traditional linear odontometric measurements. Apart from these, alternative dental measurements have been developed such as the crown and cervical diagonal diameters and mesiodistal and buccolingual cervical diameters of teeth. AIMS AND OBJECTIVE: The primary objective of the following study is to assess the degree of sexual dimorphism in teeth of a North Indian population using the crown diagonal diameters and secondary is to evaluate the applicability of diagonal measurements in sex determination by means of discriminant functional analysis. MATERIALS AND METHODS: The study sample comprised 200 individuals (100 males and 100 females) of an age group ranging from 18 to 57 years, in a North Indian population. The mesiobuccal-distolingual (MBDL) and distobuccal-mesiolingual (DBML) crown diameters of seven maxillary and seven mandibular teeth on the study models were measured using digital Vernier calipers. RESULTS: The most dimorphic teeth amongst all for crown diagonal diameters are the maxillary central incisors and the least dimorphic are the maxillary second premolars. The mean diagonal crown dimensions in all but one tooth (DBML of maxillary lateral incisor) of males exceeded that of females. The difference was statistically significant in MBDL dimensions of maxillary and mandibular central incisor, canine, first and second molar and DBML dimensions of maxillary central incisor and maxillary and mandibular canine, first molar and second molar (P < 0.05). The accuracy of determination of sex by MBDL crown dimension ranges from 55% to 75% in males and 47-84% in females, while by DBML crown dimension ranges from 55% to 80% in males and 65-80% in females with the overall accuracy of sex determination ranging from 51% to 80% respectively. CONCLUSION: MBDL and DBML crown dimensions are reliable indicators and can be used along with or/and instead of linear measurements in sex determination. In situations in which it is difficult to take correct measurements of linear dimensions of teeth, these alternative odontometric measurements can be used consistently to determine sex.

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Calcifying odontogenic cyst (COC) shows extreme diversity in its clinical and histopathological features, as well as in its biological behavior. Because of this diversity, there has been confusion and disagreement on the terminology and classification of this lesion. Attempts to classify COC can be divided into two concepts: monistic and dualistic. We present a case of COC with coexisting histopathologic features of a cyst and a neoplasm, thus posing a dilemma in the terminology used to categorize and classify it.

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OBJECTIVE: To assess bacterial contamination of cellular telephone of dental care personnel, and to determine factors contributing to their contamination. MATERIALS AND METHODS: A descriptive, cross-sectional study was conducted, which included 300 people using a cellular telephone The study group (hundred in each group) comprised of Dental Health Care Personnel (DHCP), In-Hospital Personnel (IHP) and Out-Hospital Personnel (OHP) of a dental college cum hospital. Swab was wiped along the front and all sides of cellular handset and it was incubated in glucose broth. The swab was subplated onto growth media plates made with half Mac Conkey's agar and half blood agar and allowed to incubate for 48 hours at 37(o)C. Isolates were tested for antimicrobial susceptibility. RESULT: The analysis of presence or absence of microorganisms in the DHCP, IHP and OHP group showed no pyogenic growth in 28%, 31% and 41% cases respectively, the distribution of which was not significant (p>.05). Among non potential pathogens, spore bearing gram positive bacilli were seen in 20 cases of DHCP group, 16 cases of IHP group and 17 cases of OHP group; the distribution of which was not significant (p>.05) Among potential pathogens, significant differences were observed in the distribution of growth of Enterobacter (p<.001), Pseudomonas species (p<.05), Acinetobacter bacteria (p<.05) and Methicillin-resistant Staphylococcus aureus (MRSA) bacteria (p<.001) between the participants of different groups. CONCLUSION: RESULTs of this study showed that fomites such as cellular telephones can potentially act as "Trojan horses", thus causing Hospital-Acquired Infections (HAIs) in the dental setting.

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Fibromatoses are a heterogeneous group of distinct entities which differ in biological behaviour, but arehistologically very similar. This group of fibrous tumor or tumor like lesions, present considerable difficulties in pathologic diagnosis. Aggressive fibromatosis (AF) of the oral or para-oral structures is a very uncommon finding and its intra-osseous component is even relatively unusual. Such lesions with their origin from within the bone are termed desmoplastic fibromatosis (DF). These lesions must be distinguished from other fibroblastic tumors of the head and neck such as benign fibrous histiocytoma (BFH), fibrosarcoma, nerve sheath tumors and tumors of muscular origin. The major challenge in dealing with lesions of fibromatosis is to avoid an overdiagnosis of fibrosarcoma or an underdiagnosis of reactive fibrosis.Problems of differential diagnosis concern a wide range of diseases and immunohistochemical analysis may be helpful in diagnosis. With respect to the patient's post-operative well-being and if periodic follow-ups are guaranteed, the tumor should be carefully resected with only narrow safety margins. A rare case of aggressive desmoplastic fibromatosis in a 12-year-old girl is presented in this article with emphasis on the need and challenges for diagnosing such lesions as they have to be differentiated from other soft tissue tumors which display borderline pathological features regarding benign or malignant behaviour. Synonyms listed for the same include extra-abdominal desmoids, extra-abdominal fibromatosis, desmoids tumor, aggressive fibromatosis, juvenile desmoids-type fibromatosis, infantile fibromatosis.

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AIM: The aim of this study was to determine awareness of biomedical waste (BMW) management policies and practices among dental professionals and auxiliary staff in a dental hospital/clinics in Amritsar, India, to inform the development of future policies for effective implementation of BMW rules. METHOD: The study involved 160 staff members at the Amritsar hospital/clinics (80 dentists and 80 auxiliary staff) to whom a questionnaire was distributed regarding policies, practices and awareness relating to BMW. The questionnaire was first piloted. Completed questionnaires were returned anonymously. The resulting data were statistically tested using the chi-square test for differences between the dentists and auxiliary staff. RESULTS: In respect of BMW management policies, there was a highly significant difference in the responses of the dentists, whose answers suggested far greater knowledge than that of the auxiliaries (P<0.001). Regarding BMW management practices, the dentists were significantly more aware (P<0.001) of the method of waste collection in the hospital and the disposal of various items into different colour-coded bags. As for employee education/awareness, there was a significant difference (P<0.05) between the dentists and the auxiliaries on the question regarding records of BMW maintained in the hospital and the other responses to questions on these topics had a highly significant (P<0.001) difference between the two groups in favour of the dentists. CONCLUSION: The results of this study have demonstrated a lack of awareness of most aspects of BMW management among dental auxiliary staff in the dental hospital/clinics in Amritsar and a lack of awareness of some aspects among dentists who work in the hospital/clinics. The results provide the hospital authorities with data upon which they can develop a strategy for improving BMW management.

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Odontogenic cysts commonly encountered in dental practice are the radicular cysts and dentigerous cysts. Apart from the developmental origin of dentigerous cysts, an inflammatory origin has also been suggested. It has been reported that inflammation progressing from the root apex of the deciduous tooth brings about development of the dentigerous cyst around the unerupted permanent tooth. The aim of the present article is to report 4 additional cases of dentigerous cyst believed to be of inflammatory origin and to highlight the diagnostic dilemma in segregating both the entities. The 4 cases were of patients with a mixed dentition with the pathology related to the deciduous tooth present. Radiographically, pericoronal radiolucency was seen attached at the cementoenamel junction of impacted tooth and in continuation with lamina dura of deciduous tooth. Microscopically, the cystic cavity was lined by reduced enamel epithelium like lining, which was hyperplastic to anastomosing in areas in few cases. This study proposes the predicament in accurately diagnosing such cases.

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Adenomatoid odontogenic tumor (AOT) is an uncommon tumor of odontogenic origin composed of odontogenic epithelium in a variety of histoarchitectural patterns. Most cases are in females and have a striking tendency to occur in the anterior maxilla. However, AOT of the maxillary antrum is extremely rare. A 25-year-old female presented with a large radiolucent lesion associated with the crown of an unerupted canine located in the maxillary antrum, which was clinically diagnosed as dentigerous cyst. The microscopic examination revealed the presence of AOT in the fibrous capsule of a dentigerous cyst. Very few cases of AOT associated with dentigerous cyst have been reported till date. A case of gigantic AOT that occupied the maxillary sinus and associated with dentigerous cyst is described. Also, an attempt has been made to determine whether the AOT derived from the dentigerous cyst could represent a distinct hybrid variety.